On Thursday, according to previous arrangements, Zhao Yuan needed to go to the pediatric rotation department.
To be honest, Zhao Yuan was quite worried about the work of pediatrics. Thinking of the "wow wah wah" cry, his head started to buzz.
Zhao was originally very confident, thinking that he was competent in any department, but this experience in pediatric rotation told him that this was not the case.
Occasionally treating children is okay, but letting him stay in the pediatric department all day and deal with unreasonable little patients is absolutely unsustainable.
One of the main tasks of the Department of Pediatric Internal Medicine is outpatient care. Patients with serious conditions will be admitted and treated, and most patients do not need to be hospitalized.
Several patients came in one after another, all suffering from colds, coughs and fevers. After a brief examination, Zhao Yuan gave them prescriptions.
Clinically, it is extremely common for children to be infected with viral colds. Viral infections account for about 90% of respiratory colds. Common viruses include influenza virus, parainfluenza virus, rhinovirus, adenovirus, respiratory syncytial virus, etc.
Qin Yang was still very surprised in his heart. Generally, young doctors would not dare to prescribe casually. They would at least have to do a blood test to determine the cause of the child's disease, whether it is a virus, mycoplasma, or inflammation, before prescribing medicine. But Zhao Yuan did not have this process.
, the patient's condition can be determined by just palpation, pulse diagnosis, and questioning.
Only experienced doctors will do this.
However, based on Qin Yang's experience, Zhao Yuan's diagnosis was still very accurate despite the lack of assistance from the examination report.
"Xiao Zhao, if all pediatricians treat diseases the way you do, they will probably go bankrupt sooner or later." Qin Yang reminded with a smile.
Zhao Yuan was slightly startled, then realized that pediatrics is different from emergency surgery. Emergency surgery relies on surgery fees, while pediatrics relies on examination fees and medication fees, of which examination fees account for the majority.
Zhao Yuandao: "It's a waste of time to do the examination, wait for the report, and then have to follow up. Since we can determine the condition, there is no need to be formalistic."
Qin Yang nodded slightly, "If you can determine the patient's condition without any necessary steps, of course you can save more. How do you determine the patient's condition? Aren't you afraid of making mistakes?"
Zhao Yuan smiled at Qin Yang and said, "With you, a pediatrician, sitting next to me, if I make a mistake, will you spare me? So you are my biggest guard of honor.
The previous patients had upper respiratory tract infections, with symptoms such as fever, nasal congestion, runny nose, sneezing, sore throat, and cough. Generally, runny noses are clear noses. If a child has a yellow nose, it means there is a bacterial infection.
Oral medication is enough to cure these conditions, such as Pudilan Anti-inflammatory Oral Liquid, Qingkailing Oral Liquid, Shuanghuanglian Oral Liquid, Xiaoer Chiqiao Qingre Granules, Bairui Granules, etc.”
Qin Yang nodded in approval, "Your research is quite thorough."
Zhao Yuanxin said that he was able to make an immediate diagnosis and relied on solid enough physical examination techniques to understand the patient's symptoms and confirm them through the patient's physical reaction. Although the child cannot speak, the physical reaction will not lie. If there are special
In this case, abnormalities can be found through physical examination.
While they were talking, a new patient came in. The child was only two or three years old. Holding him was a woman wearing a black skirt, followed by four old people, who were probably the child's grandparents.
This is the current situation in China. Children are the treasure of a family, and the whole family is rarely disturbed.
A woman worked in a bank and received a call from her mother saying that her son seemed to be unable to move his arm. She immediately asked for leave and took her child to the hospital for treatment.
"Doctor, my son can't seem to move his arms and has been crying. We don't know why!" the woman said nervously.
Grandpa had a bad temper and frowned at his wife: "Did you accidentally let him fall?"
The child is usually taken care of by the grandma. If the child is not taken care of well, I have no choice but to keep my eyes red and keep silent.
The grandparents next to me seemed to be comforting, but there was a sense of complaint in their words.
The five people were giggling, and the little boy was bleating and crying out in pain. Zhao Yuan felt that his head was as big as a bucket.
"Please be quiet for a moment!" Qin Yang noticed Zhao Yuan's strangeness and reminded him.
The few people finally stopped arguing, and Zhao Yuan had finished the inspection.
"After the examination, it was found that the arm was dislocated, nothing serious."
"Dislocated? How did it happen?" The woman looked at Zhao Yuan in surprise. She found that Zhao Yuan was not very old. "Are you going to take an X-ray?"
Zhao Yuan sighed, "I probably won't be able to see it in the film."
The woman frowned and said, "You're such a funny doctor. After a casual check, you said my son had a dislocation, and you couldn't find it even with a X-ray. Do you mean you're better than a machine?"
Zhao Yuan could only explain patiently, "Subluxation of the radial head in children cannot be seen on X-rays."
Radial head subluxation is the most common joint dislocation in children before the age of 6. Because the radial head in children before the age of 6 has not ossified and is still in a cartilage state, and the cartilage is not shown on X-rays, the dislocation cannot be seen on X-rays.
The woman also had a hot temper. Thinking that Zhao Yuan wanted to evade and torment herself and the child, she smacked the table with both hands and completely exploded.
"You are too irresponsible as a doctor, aren't you? You must not have children. You don't know how it feels to be a parent. Seeing a child cry is more uncomfortable than having an accident yourself."
Zhao Yuan was also speechless. He originally wanted to tell the other party that the examination was useless and that the child's condition could be determined without examination.
"Don't get excited!"
"How could I not be excited? He has been crying for hours. If he keeps crying like this, my heart will break."
Zhao Yuan knew that continuing to talk to the woman would be a waste of time.
He moved the child in front of him and pointed to the child's left arm, "Does it hurt here?"
When the woman saw that Zhao Yuan ignored her, she was a little at a loss. She didn't know what Zhao Yuan wanted to do.
The child was two or three years old and could only speak simple short words. He nodded with tears in his eyes, "It hurts!"
Zhao Yuan took out a lollipop from the drawer and stuffed it into his right hand. The child's attention was distracted and he stopped crying immediately.
At this moment, Zhao Yuan grabbed the child's left arm, rotated it backwards, extended his elbow and pulled it slightly, pressed his thumb on the head of the radius, quickly and gently swung the elbow joint, and then rotated the forearm.
It definitely didn't last more than five seconds before there was a "click" and the child exclaimed.
Zhao Yuan took a deep breath and the reset was successful.
The child's grandmother was about to say, "The baby doesn't eat candy!"
As soon as the word "baby" was mentioned, the treatment was over.
Zhao Yuan let go and said, "You can go."
Mom reacted quickly, "Doctor, is this okay?"
Zhao Yuan nodded towards the woman, "It has been reset! You should be careful in the future. Don't pull the child's hands casually. Sometimes, even a seemingly light movement may dislocate his bones."
The woman's face was full of shame, "I'm sorry, I was too excited just now and my tone of voice was too harsh. I apologize to you."
Zhao Yuan did not care about the woman. He met so many patients and family members every day. Without a strong mentality, he would not be able to adapt to this job. "Next time, I will be more merciful. Although I am not married and have no children, I still face patients."
Pain, I am no easier than you."
The woman was even more ashamed and ashamed.
Grandma asked softly from the side: "Doctor, how did he dislocate his joint? I just went to the kitchen for a while and I didn't see him fall anywhere."
Zhao Yuan observed the child and thought carefully, "Who dressed him today? The sweater underneath was worn inside out."
Grandma was surprised, "His grandpa helped him wear it. He usually wears it for him."
Zhao Yuan nodded slightly, "That's right! When I was getting dressed, grandpa didn't pay attention and twisted his arm."
Grandpa's face turned pale, his mouth trembled, he lowered his head in shame and said nothing.
He actually knew that when he was helping his grandson get dressed, the child's arm made a crisp sound.
I originally thought I could hide it...
After the family left, Qin Yang couldn't help but sigh:
"I didn't expect Dr. Zhao to have the ability to solve cases!"
